In July 2023, CHA sent a letter to the Defense Health Agency (DHA) to request a delay in the effective date of a final rule that ends the exemption for children’s hospitals from TRICARE’s outpatient reimbursement methodology which is based on Medicare’s Outpatient Prospective Payment System (OPPS).
The letter to DHA notes that children’s hospitals that care for children covered by TRICARE need sufficient time to analyze the implications for their individual institutions of the reimbursement change and make the requisite system changes to allow them to comply with OPPS. The letter also asks the DHA for additional information regarding the underlying assumptions and methods that were used in the rule’s fiscal impact analysis to support the financial modeling necessary to fully understand the implications for children’s hospitals.
